BasicsIsotretinoin
is one of the strongest and most successful medicines available for the treatment
of acne. It is indicated for severe acne (nodulocystic types) or for persistent
acne that is not responding to other types of therapy. Isotretinoin has received
a lot of negative press and several issues are part of the hot
topics section. Despite the media frenzy however, isotretinoin remains an
extremely helpful medication in the fight against acne and when used correctly
can be admininstered with minimal side effects.

How
it worksIsotretinoin is a complete medication in that it is the only medication
that tackles all of the key factors in acne production. It inhibits oil gland
formation hs well as reduces the size of existing oil glands decreasing the
amount of sebum production. In addition is decreases the conversion of androgen
hormones that contribute to further oil production as well as decresing the amount
of androgen hormone receptors. Isotretinoin also normalized they way the skin
turns over, decreasing "stickiness," helping the skin to slough more
regularly, and helping to make sure that pores to not get blocked. Finally,
isotretinoin is anti-inflammatory as it block certain cells that contribute
to inflammation and pimple formation.

Types
of isotretinoinFor many years isotretinoin was available as Accutane.
Today, there are several generic equivalents tha exist including Amnesteem and
Clarivis.

Potential
side effectsThere are many potential side effects with isotretinoin. The
most severe side effect is birth defects that can occur when pregnany women
take isotretinoin. This is the main reason that isotretinoin is under such strict
regulation and why monitoring is so strict during isotretinoin therapy. Women
who are pregnany or who are trying to conceive, should not take isotretinoin.

Most
commonly, people who take isotretinoin will experience dryness, mostly of the
lips and occassionally other area of the body like the tops of the hands. Other
potentail side effecs include increased liver enzymes, increased triglyceridese
and cholesterol, muscle aches, headaches, altered vision (particularly night vision),
hair loss, and mood swings.

There
has been a lot of press regarding isotretinoin and depression. While there have
been anecdotal stories of isotretinoin causing severe depression, recent studies
indicate that those on isotretinoin actually are less depressed than those
not on isotretinoin. See our hot topics
section for more on isotretinoin and depression.

Prior
to starting isotretinoin you should make sure that you have a thorough talk with
your prescribing physician and that all of your questions are answered. The good
news is that despite all of the potential side effects, that aside from some dryness,
isotretinoin is usually very well tolerated with excellent results.

Ways
of minimizing side effectsThe important factor in isotretinoin therapy
is achieving a total dose that is based on weight. How fast that total is
achieved is less important. What this means is that by decreasing the dose
and staying on the medicine a bit longer, the same results can be obtained while
minimizing potential side effects.

In
addition to this good skin care and the use of moisturizers can help with dryness.
Over the counter products like Aquaphor (lips), Ocear Nasal Spray (nose), and
eye drops can help fight dryness as well.